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A multi-model study of the association between BMI and AMH in Chinese women
Zhen Wang1, Yanfei Liu1, Yonghai Shen1
1Department of Clinical Laboratory, Hangzhou Women's Hospital , Hangzhou, China.
Objective:
To determine whether body mass index (BMI) is associated with anti-Müllerian hormone (AMH) in Chinese women and whether PCOS, age, or testosterone modifies this association.
Methods:
We analyzed 670 women (20-39 years) from Hangzhou Women's Hospital. Primary analyses included linear regression and generalized additive models (GAMs) with thin-plate splines, and multi-group structural equation modeling to test PCOS effect modification. Secondary analyses included interaction tests and Chinese BMI category comparisons. All models were adjusted for age, follicle-stimulating hormone, luteinizing hormone, and testosterone.
Results:
BMI showed no significant linear association with log-AMH (β = 0.008; adjusted R2 = 0.398). GAMs confirmed a near-linear relationship without threshold effects. However, underweight women (BMI < 18.5 kg/m2) had significantly lower log-AMH than normal-weight women (β = -0.14, P = 0.036), with no significant differences for overweight or obese categories. PCOS did not modify the BMI-AMH association.
Conclusion:
BMI is not a clinically meaningful predictor of ovarian reserve as a continuous variable. Lower AMH in underweight women highlights a subgroup warranting attention in reproductive assessments, while PCOS status does not influence this relationship.
